The Care Quality Commission
  • Services in your home
  • Homecare service

Archived: Age UK Newcastle

Overall: Requires improvement read more about inspection ratings

Fifth Floor, Hadrian House, Higham Place, Newcastle Upon Tyne, Tyne and Wear, NE1 8AF (0191) 232 6488

Provided and run by:
Age Concern Newcastle Upon Tyne

Important: This service was previously registered at a different address - see old profile

All Inspections

21 and 22 October 2015.

During a routine inspection

This inspection took place on 21 and 22 October 2015 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to ensure the registered manager was available to assist the inspection.

We last inspected this service in July 2014. At that inspection we found the service was meeting all the legal requirements in place at the time.

Age UK Newcastle is a domiciliary care agency that provides personal care to adults and older people, some of whom may have a dementia-related condition. It does not provide nursing care. It provided personal care to 66 adults and older people at the time of this inspection.

The service had a registered manager who had been in post for one year. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

All staff had been trained to recognise and respond to any safeguarding issues. The service acted appropriately in reporting such issues to the local safeguarding adults unit. People told us they felt safe when their care workers were in their house. However, the service had failed to notify the Care Quality Commission about a number of safeguarding incidents.

Risks to people and to staff were assessed, and appropriate control measures were put in place to minimise harm to people. Accidents were recorded and analysed, to see if any lessons could be learned. Plans were in place to keep people safe in the event of an emergency such as severe weather or sudden staff shortages.

The registered manager was aware of the new legal Duty of Candour they owed to people, where something had gone wrong with their care.

There was sufficient staff hours available to meet people’s needs safely and effectively. Staff recruitment was professional and robust, and ensured unsuitable applicants were not employed.

Staff were trained in the safe administration of people’s medicines and had their competency to do so checked regularly.

Staff received a wide range of training to enable them to meet people’s needs. Staff were given support by means of supervision and annual appraisal. People told us they felt staff had the skills they needed.

People were asked to give their consent to their care. However, where people were not able to give informed consent, their rights under the Mental Capacity Act 2005 were not being fully protected.

People were supported with their nutritional needs and with their general health needs.

People told us their care workers were very kind and caring and treated them with respect at all times. They said their privacy and dignity were protected and they were encouraged to be as independent as they were able.

People were provided with information about their rights and about the services available to them, such as benefits checks and lunch clubs.

People and their relatives were involved in deciding what their care needs were and how they wished them to be met. Care plans were clear and detailed, and reflected people’s preferences. Regular meetings were held to review each person’s care.

The service recognised the danger of social isolation affecting people’s well-being. People were encouraged by staff to maintain interests, contact with their families and use local community facilities such as day centres and lunch clubs.

The service had recently gone through a major review of its aims and objectives. It had concluded it would be better able to meet people’s needs by withdrawing from its contract with the local authority and providing services mainly to people funding their own care. The provider told us this had given them the scope to plan services which were not constrained by rigid time slots and which would be more centred on the needs of the individual. As a result, the service now provided services to a smaller number of people and was able to demonstrate a significantly better person-focussed approach.

The management team was open, responsive, approachable and keen to improve the quality of the service in all areas. Systems were in place to monitor the performance of the service. People told us they felt they were listened to and were able to influence how their service should be given.

The service had forged links with other Age UK branches to explore potential for economies of scale, share best practice and organisational learning.

We found breaches of the Health and Social Care Act (Regulated Activities) Regulations 2010 in relation to obtaining people’s consent to their care and the notification of incidents. You can see what action we told the provider to take at the back of the full version of this report.

8, 9 July 2014

During an inspection looking at part of the service

We undertook this inspection to follow up on areas of non-compliance identified at our last inspection in April 2014. At that inspection, we had identified concerns with the provider's arrangements for the recording, handling and safe administration of medicines; and found that the provider did not have an effective system to regularly assess and monitor the quality of service that people received.

On this inspection we found people were protected against the risks associated with medicines because the provider had improved arrangements in place to manage medicines. These included the introduction of an appropriate policy for managing people's prescribed medicines; improved systems for recording the administration of people's medicines; care workers had been given appropriate training in the safe handling of medicines; and checks had been carried out to assess the competence of care workers in assisting people with their medicines. People told us that they were satisfied with the way their medicines were handled.

We found improvements in the systems used to assess the quality of the service being provided. A range of new systems had been introduced, including systems for organising the allocation of appropriately trained care workers to meet people's needs; planning care to better meet people's preferences; and improving the checks on people's care records and the records of staff training, supervision and appraisal. The provider was able to demonstrate that the service was more responsive to concerns or complaints raised regarding people's care, and had taken steps to address these. Examples included the imminent introduction of systems to monitor the times and duration of care workers' visits to people, allowing late or missed calls to be picked up and responded to promptly.

15, 16 April 2014

During a routine inspection

We considered our inspection findings to answer questions we always ask;

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well-led?

Below is a summary of what we found.

Is the service safe?

Before any care was given to a person using the service, a risk assessment of their home environment and of any other areas of risk were carried out. Appropriate actions, such as providing equipment and giving staff extra training, were put in place to minimise identified risks. People using the service said they felt safe when their care workers were in their homes giving them their care. One person told us 'I feel absolutely safe' when with her care worker. A relative told us she felt her husband was safe when out with his care worker and said he was always treated with respect and dignity. Systems were in place for safeguarding people using the service and for reporting any allegation of abuse.

The suitability of new staff to work with vulnerable people was checked before they were employed.

The systems in place for the management of people's medicines were not always effective and this put people at some risk, including late and missed calls to assist with medicines. Some episodes of missed medication calls had resulted in referrals to the local safeguarding team. We are taking action to ensure the management of people's medicines by the provider becomes safe.

Is the service effective?

People who used the service said staff mostly understood their care and support needs and that staff listened to their needs and responded to them. People expressed a high degree of satisfaction with the quality of care they received from their regular care workers. However, there were repeated comments about poor organisation of their care from the office, and references to late and missed calls. New computerised systems were being introduced to improve the effectiveness of planning people's care and the organisation of care workers' rosters.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. Significant improvements in the levels of support and training of staff had taken place over the previous year. Staff had received appropriate training to meet the needs of the people receiving a service.

Is the service caring?

People were supported by kind and attentive staff. They told us their regular care workers were very caring, knew them well and always treated them with respect. One person told us 'The care is fine, just fine'; a second person said, 'The carers are fantastic, every carer is fantastic'; a third said, 'My care is excellent.' People were less happy with the care they received when their regular carers were not available.

Is the service responsive?

People's needs had been assessed before they received a service. Records confirmed that people's preferences, interests and diverse needs had been recorded and care and support was provided in accordance with people's wishes. People said that staff listened to their needs and responded to them, but some people were not satisfied with the way their complaints had been addressed.

Is the service well-led?

The service had not had a registered manager in post for over a year at the time of this inspection. An interim manager with the relevant qualification and experience had been in post for part of this period and a new manager had recently been appointed and was about to take up post. This had significantly impacted on the management of the service provision, and had led to care workers not always feeling they were fully supported. Many staff did not feel the management team had created a good working atmosphere. Staff were in the process of being consulted about significant changes to the structure and duties of the office-based team supporting the care workers.

People using the service, their relatives and other stakeholders were asked to complete an annual satisfaction survey. One had just been completed and we saw actions were planned to correct any shortfalls identified. Other quality assurance processes were in place, but they were not all fully carried out, due to staff turnover and other staff issues. We are taking action to ensure quality systems become properly effective.

21 March 2014

During an inspection looking at part of the service

We carried out this inspection to check that the provider had taken appropriate actions to become compliant with this standard. We found that staff were being given formal supervision and appraisal at the appropriate frequencies, and that an adequate programme of staff training was in operation. This meant people who used the service had their needs met by staff who had the necessary support to provide them with safe and appropriate care.

10, 11, 23 July 2013

During a routine inspection

People had not been asked to give their formal, written consent to their care and treatment, before receiving a service.

People's needs had not always been properly assessed, and their care plans had not been kept up to date. This meant it was not clear that all their care needs were being met.

Feedback from people who used the service was generally positive about their care workers. One person's spouse told us the care his wife received was, "Excellent" and spoke of the "good rapport" they had with their carer workers. Another person said of her care workers, "They are so kind and caring."

Suitable arrangements were in place for identifying the possibility of abuse and for the prevention of abuse. Safeguarding concerns had been reported quickly and appropriately.

Suitable arrangements had not been put in place for the recording and administration of people's medicines, nor had appropriate training been given to staff.

Recruitment and selection policies and procedures ensured that only appropriate staff were employed to care for people using the service.

Staff were not receiving regular supervision or appraisal of their work; nor were they being given the necessary training to meet people's needs.

The provider did not have an effective system to regularly assess and monitor the quality of service that people received.

Accurate records were not being kept of the care and treatment given to people using the service.

4 May 2012

During a routine inspection

The manager told us that people who used the service preferred to be known as 'customers': that phrase has been used throughout this report.

We visited three customers in their own homes, with their advance agreement, and also talked with one relative.

People expressed a high degree of satisfaction with the service they were receiving. They told us they had been given good information about the service and that they felt they had input into how their care was organised and given. They spoke highly of their care workers, particularly their regular staff.

We were told that staff were caring and sensitive, and were flexible and responsive to any requests for changes to their care. Staff were described as being reliable and punctual, as well as being respectful and discrete.

People told us they had confidence in their care workers and felt safe and relaxed when they were in the house. They also felt that the management of the agency listened to their views and usually acted upon them.

No one had any serious concerns, although the issue of messages not always being passed on at the office was raised. Other than this, no one was able to suggest any improvements the agency could make.